The incidence and prevalence of treated end-stage renal disease (ESRD) has increased relentlessly in the U.S. since initiation of the Medicare ESRD Program in 1973, emphasizing the national need to train more scientists to study this societal health problem. Renal disease epidemiology offers the potential to help reduce the morbidity, mortality and societal costs associated with ESRD by applying basic scientific discoveries at the patient and community level. As such, it is a natural complement to the substantial strengths in basic science research in renal disease. This proposal is a competitive renewal application, years 11 to 15, for a NRSA to fund a Renal Disease Epidemiology Training Program at The Johns Hopkins Medical Institutions. The Program is based in the Welch Center for Prevention, Epidemiology, and Clinical Research and the Department of Epidemiology;it takes advantage of the faculty's strengths in the application of epidemiologic methods to important issues in renal disease and their ability to bridge the disciplines of basic science and epidemiology. A program Director (Dr. Klag), co-director (Dr. Powe), and 6 nationally recognized renal disease epidemiologists serve as faculty advisers;8 other faculty with experience in renal disease epidemiology will also be available for mentorship. An Advisory Committee of institutional leaders and nationally recognized researchers and teachers in renal disease will advise the directors and monitor progress. In the first 10 years of the program, we have demonstrated our ability to recruit high quality candidates and rigorously train them in clinical and epidemiologic renal research methods. A total of 10 trainees have been supported (4 still in training), of whom 6 are now principal investigators of NIH grants. The trainees have produced a total of 126 publications. This funding has revitalized the Pediatric Nephrology fellowship at our institution and has forged close collaborative relations between faculty in the Department of Epidemiology, the Welch Center, and the Divisions of Adult and Pediatric Nephrology. Lastly, this program has profoundly influenced the curriculum and research agenda of the Johns Hopkins Medical Institutions